Ellsworth Community Music Institute Lesson Inquiry Form

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Ellsworth Community Music Institute Lesson Inquiry Form - 2023

Thank you for your interest in lessons at Ellsworth Community Music Institute (ECMI).
We ask that you complete this inquiry form to begin our communications.
Once received, our Artistic Director will be in touch. We look forward to speaking with you!

Student First Name *

Student Last Name *

For Students 18 or under:

Student Date of Birth

YYYY

Name of School and Grade Level

Parent or Guardian Full Name

Primary Contact Email *

If no email, please enter "N/A" and include phone below.

Primary Phone Number *

Mailing Address

Musical Background (previous study, reading music, etc):

What type of instruction do you seek?

Instrumental

Vocal

Other:

Please select your preference for instruction.

Individual lessons

Ensemble

Other:

If instrumental, please enter the instrument.

Do you possess the instrument you want to study at ECMI?

Yes

Other:

Clear selection

Where did you hear about ECMI?

Comments or Questions

(Please let us know if you are currently a student of an ECMI faculty member.)

Submit

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